Panuveitis with positive serological tests for syphilis and Lyme disease

The Treponema pallidum hemagglutination test and the fluorescent treponemal antigen absorption test are commonly considered highly specific serologic tests for syphilis. We describe a patient with panuveitis and a positive serologic result for syphilis; however, in the absence of clinical findings, additional tests for Lyme disease (borreliosis) were positive as well, although by Western blot test the diagnosis was tentative. The clinical appearance of the panuveitis was similar to that of syphilitic uveitis accompanied by pseudopigmentosa-like areas in the anterior retina. In the presence of uveitis with an otherwise unexplained positive serologic result for syphilis, the differential diagnosis of Lyme disease should be considered.